People with eczema know that a good moisturizer is an essential part of their skin care regimen. Due to a gene variation that can prevent skin from retaining moisture, skin affected by eczema is prone to dryness, itchy rashes, and infections. Medications such as topical steroids are sometimes prescribed by dermatologists to stop inflammation. Many people also rely on over-the-counter (OTC) moisturizers — also known as emollients — that can be bought without a prescription. Moisturizers can take various forms:
Finding the right moisturizer for dryness and itchy skin can be frustrating. As one member of MyEczemaTeam wrote, “I constantly have to change moisturizers. I'll find something that'll work for a few months; then my skin goes through changes. My moisturizer is no longer effective, and I have to find a new one.”
The National Institute of Allergy and Infectious Diseases at the National Institutes of Health (NIH) recommends home skin therapy that includes lubricating or moisturizing skin two or three times each day with products that do not have alcohol, dyes, fragrances, or irritating chemicals. Specific products may work better than others depending on whether flare-ups and sensitive skin occur on the hands, face, or other parts of the body. “I use coconut oil for my scalp, but not for my face because it makes my face look so greasy,” said one MyEczemaTeam member.
Dry skin can be aggravated by wind, low humidity, cold air, harsh soaps and skin care products, and excessive washing. According to the National Eczema Association, bathing right before moisturizing is the most effective method for replacing moisture to dry skin. People with eczema should bathe at least once per day in lukewarm water and should always avoid hot water. Showers or baths are equally effective but should be limited to 10 to 15 minutes. Avoid soap and scrubbing, using a gentle cleanser instead. If you are having a bad flare-up, you may want to cut back or stop using cleansers. Talk to your dermatologist about using bath treatments, such as bath oil, baking soda, bleach, oatmeal, salt, or vinegar.
Immediately after bathing, gently pat your skin dry to avoid irritation and leave skin slightly damp. It is important to first apply any prescription ointments or topical treatments you may be using at the time. Moisturizers should be applied within three minutes to help seal in the moisture your skin has absorbed while bathing. Before dressing or applying wet wraps, the moisturizer needs to be absorbed by your skin for at least a few minutes. This is the “soak-and-seal” method of moisturizing. Keep in mind that some moisturizers may take even longer to absorb. One member shared her experience: “My doctor has suggested Epaderm as a moisturizer. I’ve had very quick results, although it takes a good half hour to soak in. It’s great for overnight use.”
Set aside ample time to “soak and seal” and give your skin the care it needs. Margaret Lee, M.D., Ph.D., an instructor of dermatology at Harvard Medical School, suggests that older children and adults with eczema might schedule “spa time” before bedtime to bathe, moisturize, and decompress. Here’s how a member described his evening treatment: “I took a warm bath with vinegar and baking soda. It really relieved the itchy burning sensation. Then, I moisturized with [prescription] Triamcinolone and some colloidal oatmeal lotion. Man, it’s heaven.”
With a dizzying array of moisturizers available without a prescription, it is easy to get confused about what is best for people with eczema. MyEczemaTeam members frequently share recommendations for products they find helpful:
The National Eczema Association (NEA) has created a “Seal of Acceptance,” which appears on some packaging and indicates that a product does not contain harmful ingredients for people with eczema. You can consult their directory of products that have been awarded the seal. Be aware that the seal is given only if a company applies for it, and some products may be effective even without the seal.
Always avoid ingredients, including fragrances and dyes, that can cause allergic reactions. In general, thicker and more emollient creams and ointments are better, but it needs to be a formulation that you can use often. For dry skin on the face, look for a moisturizer that is noncomedogenic, meaning it will not clog pores and cause acne.
The NEA’s list of ingredients that should be avoided includes:
In a report published in Dermatology Research and Practice on the role of moisturizers, creams, and lotions in protecting the skin’s barrier and treating eczema, many ingredients that can be found in OTC moisturizers were shown to be effective. It is well known that what works for one person may not work for another. Furthermore, skin may change over time, and a product that once worked well may no longer provide relief. The report shows that combining moisturizers with prescription and nonprescription corticosteroid treatments can help reduce the use of steroids, which can have side effects (including thinning of the skin) over time. Two ingredients found to be especially effective in moisturizers are petroleum jelly and oatmeal.
Vaseline and other brands of petroleum jelly showed “significant improvements” according to the Dermatology Research and Practice report. Interestingly, OTC petroleum jelly products were found to be more effective than prescriptions with petroleum jelly. Vaseline is 100 percent petroleum jelly, which some people with eczema find too messy. However, plain petroleum jelly is often recommended by dermatologists as having the lowest potential for causing allergic reactions. One member reported: “Aquaphor [which has petroleum jelly and other ingredients] does a good job as well. It’s not quite as greasy as Vaseline.” But another member prefers Vaseline: “Vaseline is the only moisturizer that helps and doesn’t irritate my hands. I lather them up multiple times a day, as it has no alcohol in it to dry out your skin.” Petroleum jelly is a very effective barrier for the skin that prevents moisture loss from the skin into the air.
Moisturizers containing colloidal oatmeal can also be beneficial. Colloidal oatmeal is oat grain that has been ground into a fine powder so that it can easily dissolve. It is commonly found in lotions, creams, and gels. Oatmeal is effective against itchiness. Colloidal oatmeal soothes and provides barrier protection, which helps skin retain moisture. It also has anti-inflammatory properties. One member recommends oatmeal in all its forms: “Had a flare-up last week. I still believe oatmeal is a wonderful soother in soap, lotions, and by itself. It’s wonderful.
Our skin naturally produces ceramides, lipid molecules with fatty acids that help protect the skin barrier. Studies have shown that people with eczema have reduced levels of ceramides. The addition of ceramides to creams and lotions has been a significant change to moisturizers that help with dry skin and eczema. OTC moisturizers with ceramides include CeraVe, which some MyEczemaTeam members have found effective. One member wrote, “If you haven’t used it yet, try CeraVe. It is an excellent lotion.” Another member reports, “I often feel as if I have tried everything on the market for itching. However, I came across a lotion I’ve not yet tried. It’s CeraVe Itch Relief Moisturizing Cream. CeraVe products generally don’t work for me, but I have to say this one actually helps.”
Some people with eczema have found relief moisturizing with natural oils and butters, such as:
These oils and other naturally sourced emollients may be helpful for some people with eczema, but be aware of the potential for allergic reactions. Olive oil can show detrimental effects and should be avoided on sensitive skin.
Coal tar has a long history as an eczema treatment. Studies show that it is beneficial for distressed skin because it restores the protective properties of proteins in the skin barrier. Many OTC moisturizers have coal tar as an ingredient, and some can be found on this list recommended by the Mayo Clinic.
Urea, ammonium lactate, and salicylic acid are other ingredients in moisturizers for people with dry, scaly skin. These ingredients peel away the top layer of skin, leaving smoother skin without scale, and are best for areas of thicker skin and very dry skin. There are both over-the-counter and prescription strengths containing these ingredients.
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